Institute for Human Health and Disease Intervention (I-HEALTH), Department of Urban and Regional Planning, Florida Atlantic University, Boca Raton, FL, USA.
Department of Mathematical Sciences, Florida Atlantic University, Boca Raton, FL, USA.
J Alzheimers Dis. 2021;82(1):221-233. doi: 10.3233/JAD-210370.
Preliminary evidence suggests associations between neighborhood park access and better late-life cognition and reduced Alzheimer's disease (AD) risk.
Examine associations between neighborhood park access and longitudinal change in cognition among U.S. older adults without dementia.
We used 2000-2018 observational data from the population-based, multi-site Multi-Ethnic Study of Atherosclerosis (n = 1,733). Measures included proportion of neighborhood park space (park access), distance to nearest park, and 6-year dichotomous and continuous change in scores on the Cognitive Abilities Screening Instrument (CASI; global cognition) and Digit Symbol Coding task (processing speed). Multivariable random intercept models tested main associations and mediation by depressive symptoms, physical activity, and PM2.5 exposure. Effect modification by race (African Americans/Blacks versus Whites) was tested using interaction terms.
Greater park access (equivalent to 10%more in 1/2-mile around home) was associated with maintained/improved CASI score over six years independent of several covariates including individual- and neighborhood-level socioeconomic status (Odds ratio: 1.04; 95%confidence interval: 1.00-1.08). No other associations were observed with the dichotomous or continuous measures of cognitive change and no mediators were found. While a borderline association was seen between greater park access and maintained/improved CASI for African Americans/Blacks but not for Whites, effect modification was not confirmed by testing interaction terms.
Neighborhood park access may help maintain/improve late-life global cognition. However, our findings need replication in other population-based studies and regions. Additionally, studies are needed to determine if associations between park access and change in cognition vary by race/ethnicity to inform intervention efforts.
初步证据表明，社区公园的可达性与晚年认知能力的提高和阿尔茨海默病（AD）风险的降低有关。
研究美国无痴呆老年人社区公园可达性与认知功能纵向变化之间的关系。
我们使用了基于人群的多地点动脉粥样硬化多民族研究（Multi-Ethnic Study of Atherosclerosis，MESA）的 2000-2018 年观察性数据（n=1733）。测量包括社区公园空间比例（公园可达性）、到最近公园的距离以及认知能力筛查工具（Cognitive Abilities Screening Instrument，CASI；总体认知）和数字符号编码任务（处理速度）得分的 6 年二分和连续变化。多变量随机截距模型测试了主要关联以及抑郁症状、身体活动和 PM2.5 暴露的中介作用。使用交互项测试了种族（非裔美国人/黑人与白人）的效应修饰作用。
与多项协变量（包括个体和邻里社会经济地位）独立，更大的公园可达性（相当于家周围 1/2 英里内增加 10%）与六年后 CASI 评分的保持/改善相关（优势比：1.04；95%置信区间：1.00-1.08）。没有观察到其他与认知变化的二分或连续测量相关的关联，也没有发现中介物。虽然在非裔美国人/黑人中，更大的公园可达性与保持/改善 CASI 之间存在边缘关联，但在白人中则没有，通过测试交互项，未证实效应修饰作用。
社区公园可达性可能有助于保持/改善晚年的总体认知能力。然而，我们的研究结果需要在其他基于人群的研究和地区进行复制。此外，还需要研究以确定公园可达性与认知变化之间的关联是否因种族/族裔而异，从而为干预措施提供信息。
